Caesarean hysterectomy is a useful surgical procedure. However, the increased blood supply to the pelvis during pregnancy, distortion of the anatomy caused by the enlarged uterus, fragility of oedematous pelvic tissues and adhesions from prior caesarean sections predispose to poor haemostasis and urinary tract injuries. In this series all the cases were done as an emergency procedure and, despite the multiple obstetric complications, there was no maternal mortality and the incidence of post-operative morbidity was low.
Paddy fish (Trichogaster pectoralis Regan) were collected from five sampling locations in a major paddy-growing area of Malaysia and analysed for organochlorine residues. During the same period, ten farming families, chosen at random from each of the five sampling sites, were interviewed. Information was obtained about the quantity of paddy fish consumed, the amount and type of pesticide used on the paddy-field, and the frequency of application.The pesticide residues found in the fish samples were aldrin/dieldrin, chlordane, HCH, and DDT. Only the projected maximum intake level for aldrin/dieldrin approached the acceptable daily intake as recommended by FAO/WHO; other residue levels were relatively low. However, this study considered only fish; the total daily intake of pesticide residues by the Malaysian paddy farmer may be considerably increased by consumption of other contaminated food.
Traditionally, Malaysian women (Malay, Indian and Chinese) breastfed their infants as a matter of course and for an extended period of time; only elite Chinese women might have resorted to a wet-nurse. But the introduction of condensed and dehydrated milk in colonial Malaya from the late nineteenth century, and the later marketing also of commercially manufactured baby foods, led to some variation in traditional practice. Structural changes, industrialiZation and urbanisation affected social as well as economic life, and again these broad changes had an impact on infant feeding. Today, few women remain unfamiliar with the wide range of infant food products sold in the most isolated provision shops. This paper focuses on key sociological factors that might predict the frequency and duration of breastfeeding and weaning patterns. The data analysed below, collected during semi-structured interviews with 278 women presenting at Maternal and Child Health Clinics in Peninsular Malaysia, are in part confusing. They suggest that the women most likely to bottle feed only or to breast feed for a short period, and to use commercial baby foods, are young, with one child only, who reside in urban or peri-urban areas and have a reasonable household income. Higher educated women, and women whose husbands are in non-traditional occupations, are also less likely to breast feed or to do so for an extended period. But the profile of infant feeding practices is by no means clear. One of the shortcomings of the study relates to the method of collection of data, and highlights the need for detailed ethnographic studies to better explore the variability and complexity of the patterns of infant feeding.
MeSH terms: Ambulatory Care Facilities; Bottle Feeding/trends*; Breast Feeding*; Diet Surveys; Female; History; Humans; Infant; Infant Food*; Malaysia; Maternal-Child Health Centers; Milk, Human; Weaning; Qualitative Research
Details of curing rituals symbolize social traumas. Western based psychiatrists are often not very successful in treating Malay patients because of the difficulty of understanding the ritual signs. This paper focusses upon cultural details as they relate to a curer. The paper begins by discussing 'medical pluralism' and proceeds to a consideration of one local healer.
Ah Yuk Je is a successful Hakka Chinese spirit medium practicing in a small Chinese community in Malaysia. Her clientele consists largely of young children suffering from a culturally specific condition called haak geng or 'soul loss' and women concerned about infertility, prenatal problems and errant spouses. While in a trance state, assisted by her tutelary spirits, she diagnoses, prescribes and treats illnesses. Her treatment includes naturalistic and magico-religious elements such as 'cooling' herbal teas, tonics to strengthen the body, rituals and amulets. Because Ah Yuk Je is a wife and mother, women find her sympathetic and astute at solving family problems. When faced with an illness herself, which she suspects to be the result of kong tao (black magic) instigated by someone in her own village, she seeks assistance from a healer outside her own ethnic group as well as outside her community. Four important factors influence Ah Yuk Je's decision to seek out this healer. The first two, recommendation from a trusted friend and a positive previous experience, are obvious, and require no further discussion. The remaining factors are the special nature of the illness, which requires treatment from a specialist, and her practice as a spirit medium. Successful spirit mediums are perceived to have a certain immunity to and control over supernatural forces. Thus the need for secrecy when a spirit medium becomes the victim of evil forces. She is able to preserve her professional reputation by consulting someone outside her ethnic group of potential clients as well as outside her physical community.
MeSH terms: Ethnic Groups; Humans; Magic*; Malaysia; Medicine, Chinese Traditional*; Medicine, East Asian Traditional*; Medicine, Traditional*
This paper attempts to analyse professional rivalry and dissonance amongst traditional Malay midwives (bidan kampung) in the Northwest areas of Peninsular Malaysia. It elucidates how techniques of symbolic and ritual communication are carefully monitored by these female specialists, to develop regular clientele and professional credibility over time. However, since an integral element of Malay midwifery is protection from and mastery over mystical forces in nature and evil spirits harboured by witches, a midwife is also an exorcist with skills rather similar to the Malay bomoh (traditional medical practitioner, usually male) except that her range of knowledge of witchcraft is limited to diagnostic and curative rituals of spirit-possession, in infants and children, young unmarried women and pregnant mothers. Within a restricted population area, professional rivalries and competition amongst midwives regularly surface in oblique attacks of witchcraft accusations where the accused strives to maintain her credibility while her accuser gradually wins over her clientele. Significantly, codes of professionalism in traditional Malay midwifery are not only determined by skill and experience, but also religiousness (faith in Islam), benevolence, virtue, diligence and a sense of equality and fair-play in the practice of the trade. These qualities are seemingly lacking in witches who are conceived to be anti-Islamic, uncompromising, manevolent and destructive. Thus, government midwives who threaten the popularity of traditional midwives by being particularly active in their work or supervising and controlling midwives in an authoritarian way, are also labelled as witches. Generally, while midwifery and witchcraft reflect two forms of knowledge that are structurally opposed, in ideology and morality, they exist within the same sphere of ritual and symbolic communication where the practitioners aided by their clients, shift from one state of dissonance to another in an attempt to regulate behaviour.
MeSH terms: Humans; Magic*; Malaysia; Medicine, Traditional*; Rural Population
This paper presents evidence from the Malaysian Family Life Survey that mothers' reports of their babies' birthweights, including reports of unweighed babies' approximate size at birth, can be used to examine many biological and socioeconomic correlates of birthweight. The study uses a sample of 5583 singleton births that occurred between 1945 and 1976. In these data, the frequency distribution of birthweights and their bivariate and multivariate relationships with the biological correlates of mother's age, baby's sex, first parity and infant mortality are consistent with those found in prospective studies. A new biological correlate, mother's age at menarche, is introduced as a proxy for the mother's nutrition during childhood. Late age at menarche is associated with lower birthweight. Other results show mothers younger than 20 years and older than 35 appear to be at greater risk of bearing small babies, but the former effect is no longer important when parity is controlled. Short interbirth intervals are associated with small babies. We attempt to distinguish whether this is due to prematurity or to maternal nutritional depletion; both effects appear to be operating. Higher income appears to mitigate the pernicious effect of short interbirth intervals. Indian babies weigh significantly less than those of other ethnic groups. Furthermore, birthweights have increased since the 1950s for Malays and Chinese, but not for Indians. The lower birthweights and lack of improvement over time for Indians appear to be due to close birthspacing, lack of access to medical care and falling incomes.
In a study with 113 Asian children in which phenobarbitone was used as the sole antiepileptic drug in 75 children, including Chinese, Malays, and Indians, the mean phenobarbitone dosage required to produce a plasma level of 15 micrograms/ml was 5.2 mg/kg/day. While the mean plasma level/dose ratio varied, the differences between the three ethnic groups were not statistically significant. Also of little difference were the ratios between the male and female groups. For those patients with poor seizure control, however, the mean plasma level/dose ratio was significantly lower than in those whose seizures were controlled. Using additional anticonvulsant drugs concurrently with phenobarbitone in 40 children raised the mean plasma level/dose ratios significantly in each ethnic group. Further, the greater age level in those given additional antiepileptic drugs might have contributed slightly to a higher mean plasma level/dose ratio.
Naturally occurring malaria, arbovirus infection and hepatitis in monkeys can be a hazard for the investigator and might interfere with the outcome of experiments. 63 young adult Macaca fascicularis from Malaysia were screened for these infections. About 1 year after their arrival in France, parasitaemia due to Plasmodium spp., was present in 6.4% of the animals and specific antibodies in 55.5%. 19 of 35 initially positive monkeys were tested again 2 years later. Parasitaemia was found in 1 of 4 monkeys and antibodies in 11 of 19 monkeys which were initially positive. 9 of the monkeys initially tested had low titres of antibodies to the Flavivirus genus. All animals were negative for the hepatitis B surface antigen and anti-HBc. The prevalence of IgG antibodies against hepatitis A was 46.0%. The implications in terms of control are discussed.
MeSH terms: Asia; Asia, Southeastern; Biology*; Breast Feeding*; Delivery of Health Care*; Demography*; Developing Countries; Economics; Educational Status; Ethnic Groups; Evaluation Studies as Topic*; Family Characteristics*; Family Planning Services; Fertility*; Geography; Government Programs*; Health; Health Planning; Health Services*; Health Services Accessibility*; Health Services Needs and Demand*; Income; Infant Mortality*; Infant Nutritional Physiological Phenomena*; Longevity; Malaysia; Models, Theoretical*; Mortality*; Nutritional Physiological Phenomena*; Organization and Administration; Population*; Population Characteristics*; Population Control*; Population Dynamics*; Research; Research Design*; Sex Factors*; Socioeconomic Factors; Program Evaluation*; Survival Rate*; Models, Economic*
MeSH terms: Age Factors; Asia; Asia, Southeastern; Behavior; Culture; Demography; Developing Countries*; Economics; Educational Status; Emigration and Immigration*; Employment*; Far East; Gender Identity*; Population; Population Characteristics; Population Dynamics*; Psychology; Research; Sex Factors*; Social Behavior; Social Change*; Social Class*; Socioeconomic Factors; Women's Rights*
"This paper will focus on ethnic differentials in the nuptiality of West Malaysia and on their evolution since the Second World War. The growing similarity of nuptiality patterns in the Malay, Chinese, and Indian communities will be outlined and the influence of age and sex distributions on the observed changes will be examined. The sources of data for this study are the 1947, 1957, and 1970 Population Censuses and the 1974 Malaysian Family and Fertility Survey."
MeSH terms: Age Factors*; Asia; Asia, Southeastern; Culture; Demography; Developing Countries; Ethnic Groups*; Malaysia; Marriage*; Population; Population Characteristics; Sex Factors*; Marital Status*; Age Distribution*; Sex Distribution*
In this paper the incidence of inhaled foreign body in the tracheobronchial tree at the University Hospital Kuala Lumpur, West Malaysia, is reviewed. Children are the usual victims. Food·related substance (peanut) is the most common foreign body, Successful removal of foreign body by bronchoscopy is achieved in the great majority of cases (86%), Prevention can be achieved by educating the parents not to give nuts to children below the age of 3 years.
Seven cases of analgesic nephropathy due to excessive ingestion of paracetamol are reported. None of these patients had been taking any other analgesic. All had radiological features of papillary necrosis. With the increasing use of paracetamol as a mild analgesic it is necessary to be aware of the possibility that paracetamol may induce analgesic nephropathy.
The parasites which occurred most frequently in 175 owned or stray dogs in Sabah were Ancylostoma spp. present in 68% of the animals. Dirofilaria immitis occurred in 70% of the adult dogs but neither D. immitis nor Spirocerca lupi were present in puppies under four months of age. The latter attained a prevalence of 30% in the adults. In contrast Toxocara canis occurred in 81% of the puppies but infrequently in older dogs. Dipylidium caninum was moderately prevalent (15 to 25%) in dogs of all ages. Ticks were the most common arthropod parasite being present on 26% of the dogs and were mainly Rhipicephalus sanguineus. Demodectic and sarcoptic mange were confirmed and fleas and lice were also recovered.